Effects of oral pregabalin on postoperative sleep of patients after video-assisted thoracoscopic surgery: a randomized double-blind controlled trial.

BACKGROUND: The aim of this study was to explore the effect of oral pregabalin at varying concentrations on postoperative sleep of patients undergoing video-assisted thoracic surgery (VATS), and to identify the optimal dosage. METHODS: A total of 120 VATS-treated patients admitted from June 2023 to October 2023 were randomly assigned to be orally administered with 75 mg pregabalin, 150 mg pregabalin and starch capsules (control group) at a 1:1:1 ratio. One capsule of pregabalin (75 mg) and one capsule of placebo with the same shape and odor, two capsules of pregabalin (150 mg), and two capsules of placebo with the same shape and odor were administered orally to patients in the three groups on the night of surgery, and in the morning and evening of postoperative days 2 and 3. The primary outcome was the incidence of postoperative sleep disturbance (PSD) on postoperative day 1 (POD1). The secondary outcomes included the St.Mary's Hospital Sleep Questionnaire (SMH), the Pittsburg Sleep Quality Index (PSQI) and pain intensity measured with a Numerical Rating Scale (NRS). Multivariate logistic regression analysis was performed to identify risk factors for PSD in VATS-treated patients. RESULTS: The incidence of PSD on POD1 in the 75 mg pregabalin group and 150 mg pregabalin group was significantly lower than that of the control group (45.0% vs. 42.5% vs. 72.5%; P<0.0167 for two-by-two comparisons of groups A and B with group C, respectively). The SMH scores at night on POD1-3 were significantly higher in the 75 mg pregabalin group and 150 mg pregabalin group than those of the control group (P<0.05). Since there was definitive lower incidence of pain in the experimental groups,the median NRS scores of the incisional pain on POD2-3 were significantly lower in the 75 mg pregabalin group and 150 mg pregabalin group (P<0.05). The incidence of dizziness in the 150 mg pregabalin group was significantly higher than that of the 75 mg pregabalin group and control group (55.0% vs. 25.0% vs. 32.5%; P<0.0167 for two-by-two comparisons of groups A and C with group B, respectively). NRS score on POD1, preoperative PSQI and Self-Rating Depression Scale scores were risk factors for PSD in VATS-treated patients. CONCLUSIONS: Oral administration of 75 mg or 150mg pregabalin for consecutive three days after VATS effectively reduces the incidence of PSD and improves the quality of sleep.

Superiority of opioid free anesthesia with regional block over opioid anesthesia with regional block in the quality of recovery after retroperitoneiscopic renal surgery: a randomized controlled trial.

BACKGROUND: Opioids are the main analgesic drugs used in the perioperative period, but they often have various adverse effects. Recent studies have shown that quadratus lumborum block (QLB) has an opioid sparing effect. The aim of this study was to further evaluate the effect of opioid-free anesthesia (OFA) combined with regional block on the quality of recovery in patients undergoing retroperitoneoscopic renal surgery. METHODS: Sixty patients undergoing elective retroperitoneoscopic renal surgery were divided into the opioid-free anesthesia with quadratus lumborum block group (OFA group, N.=30) and opioid anesthesia with quadratus lumborum block group (OA group, N.=30) using the random number table method. The main outcome measures were the quality of recovery assessed by Quality of Recover-40 (QoR-40) at the 24th postoperative hour. Secondary outcomes were postoperative pain score, postoperative opioid consumption, postoperative nausea and vomiting, time to ambulate, and time to readiness for discharge. RESULTS: The QoR-40 score on the first postoperative day was significantly higher in the OFA group than that in the OA group (175.41±6.74 vs. 165.07±4.55; P<0.05). OFA also significantly reduced postoperative pain (P<0.05) and morphine consumption at both the 24th and 48th postoperative hour (P<0.05), as well as time to ambulate, and time to readiness for discharge (P<0.05). CONCLUSIONS: OFA with regional block is superior to opioid anesthesia with regional block in the quality of recovery after retroperitoneiscopic renal surgery.

Effects of pregabalin combined with tramadol/paracetamol on acute pain in patients with CT-guided puncture localization of pulmonary nodules.

OBJECTIVE: To investigate the effects of pregabalin combined with tramadol/paracetamol on acute pain in patients with CT-guided puncture localization of pulmonary nodules. MATERIALS AND METHODS: In this randomized, placebo-controlled and single-center study, 120 patients were allocated randomly to four groups: the control group (Group P), the pregabalin-placebo group (Group BP), the tramadol/paracetamol-placebo group (Group AP), and the pregabalin-tramadol/paracetamol group (Group AB). The primary outcome was the NRS (Numerical Rating Scale) score. Other outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), pulse oxygen saturation (SpO2), the incidence of moderate to severe pain, the analgesia recovery ratio, the incidence of adverse drug reactions and patients' satisfaction. RESULTS: No significant interaction was detected between the interventions (P = 0.752). The NRS score of the Taking pregabalin group and the Taking tramadol/paracetamol group were significantly lower than those of the Not-taking pregabalin group and the Not-taking tramadol/paracetamol group respectively (P < 0.05). There was significant difference in the NRS scores among the four groups (P < 0.001). The NRS score of Group AB was significantly lower than that of Group P (P < 0.001), Group BP (P < 0.001) and Group AP (P = 0.001). At the same time, the NRS scores of Group BP (P < 0.001) and Group AP (P < 0.001) were significantly lower than those of Group P, but there was no significant difference between Group BP and Group AP (P = 1.000). The SBP, DBP, HR, the incidence of moderate to severe pain and the analgesia recovery ratio of Group AB were significantly lower than those of Group P (P < 0.05), while the SpO2 and the number of people who were very satisfied were significantly higher than those of Group P (P < 0.05). There was no significant difference in the incidence of adverse drug reactions among the four groups (P = 0.272). CONCLUSIONS: The combination or single use of pregabalin and tramadol/paracetamol can effectively relieve the acute pain after localization. Pregabalin combined with tramadol/paracetamol has the best analgesic effect and significantly reduces the hemodynamic fluctuations, with high safety and low incidence of adverse drug reactions, which has a certain clinical popularization and application value.

Anesthetic Management of One-Lung Ventilation in Patients With Tracheal Bronchus: A Narrative Review.

Tracheal bronchus is a rare congenital tracheal abnormality that generally refers to the right upper lobe bronchus of the lung that originates from the trachea. Tracheal bronchus is usually asymptomatic and is often accidentally detected by fiberoptic bronchoscopy or computed tomography for other conditions. Depending on the location of the tracheal bronchial opening and possible anatomical variations, the management of 1-lung ventilation in patients with tracheal bronchus is a significant challenge for anesthesiologists. To provide a reference for anesthesiologists to better manage anesthesia in such patients, we review the pathophysiology, definition, and Conacher classification of tracheal bronchus and then discuss the diagnosis of tracheal bronchus and management of 1-lung ventilation during anesthesia according to the Conacher classification.

Is AI 3D-printed PSI an accurate option for patients with developmental dysplasia of the hip undergoing THA?

BACKGROUND: In traditional surgical procedures, significant discrepancies are often observed between the pre-planned templated implant sizes and the actual sizes used, particularly in patients with congenital hip dysplasia. These discrepancies arise not only in preoperative planning but also in the precision of implant placement, especially concerning the acetabular component. Our study aims to enhance the accuracy of implant placement during Total Hip Arthroplasty (THA) by integrating AI-enhanced preoperative planning with Patient-Specific Instrumentation (PSI). We also seek to assess the accuracy and clinical outcomes of the AI-PSI (AIPSI) group in comparison to a manual control group. METHODS: This study included 60 patients diagnosed with congenital hip dysplasia, randomly assigned to either the AIPSI or manual group, with 30 patients in each. No significant demographic differences between were noted the two groups. A direct anterior surgical approach was employed. Postoperative assessments included X-rays and CT scans to measure parameters such as the acetabular cup anteversion angle, acetabular cup inclination angle, femoral stem anteversion angle, femoral offset, and leg length discrepancy. Functional scores were recorded at 3 days, 1 week, 4 weeks, and 12 weeks post-surgery. Data analysis was conducted using SPSS version 22.0, with the significance level was set at α = 0.05. RESULTS AND CONCLUSION: The AIPSI group demonstrated greater prosthesis placement accuracy. With the aid of PSI, AI-planned THA surgery provides surgeons with enhanced precision in prosthesis positioning. This approach potentially offers greater insights and guidelines for managing more complex anatomical variations or cases.

Expression profiling of the phenylalanine ammonia-lyase (PAL) gene family in ginkgo biloba L.

The PAL gene family plays an important role in plant growth, development, and response to abiotic stresses and has been identified in a variety of plants. However, a systematic characterization is still lacking in Ginkgo biloba. Using a bioinformatics approach, 11 GbPAL members of the PAL gene family identified in ginkgo were identified in this study. The protein structure and physicochemical properties indicated that the GbPAL genes were highly similar. Based on their exon-intron structures, they can be classified into three groups. A total of 62 cis-elements for hormone, light, and abiotic stress responses were identified in the promoters of GbPAL genes, indicating that PAL is a multifunctional gene family. GbPAL genes were specifically expressed in different tissues and ploidy of ginkgo. These results provide a theoretical basis for further studies on the functional expression of the GbPAL genes.

A chitosan and hyaluronic acid-modified layer-by-layer lubrication coating for cardiovascular catheter.

Despite the fact that transcatheter cardiovascular interventions are increasingly prevalent nowadays, friction damage caused by mechanical interaction between blood vessel and cardiovascular catheter limit their therapeutic utility. Based on dopamine-modified hyaluronic (HA-DN) acid and chitosan (CHI), a layer-by-layer lubricating coating for cardiovascular catheters was designed and assessed in this work. Results showed that the CHI/HA-DN composite coatings became more hydrophilic as the deposition layers were increased. The (CHI/HA-DN)8 assembly effectively reduced the coefficient of friction (COF) and related frictional energy dissipation. Besides, the fluorescent intensity, number of nucleus, SEM morphology and histological slices after friction experiment demonstrated that the (CHI/HA-DN)8 coating can protect the aorta from mechanical injury related to the control group. In conclusion, the CHI/HA-DN assembly can provide an alternative selection for low-damage lubricating cardiovascular catheter.

Catechol-modified chitosan hydrogel containing PLGA microspheres loaded with triclosan and chlorhexidine: a sustained-release antibacterial system for urinary catheters.

Blockage and infection are common in hospitals, especially with long-term indwelling catheters, due to bacterial adhesion, colonization, and other reasons. A drug-sustained-release antibacterial coating for urinary catheters was described in this paper. Chlorhexidine (CHX) and triclosan (TCS) were encapsulated in poly(lactic-co-glycolic acid) microspheres and mixed with a modified chitosan hydrogel deposited on the surface of silicone rubber. The results showed that drugs can be released continuously more than 35 days. Catechol-modified chitosan (Chi-C) hydrogel was successful synthesized according to FT-IR and UV spectrophotometry, as well as 1H NMR. Furthermore, the coating with CHX and TCS presented stable antibacterial ability compared to the other groups. The results of CCK-8 revealed that the coating was cytotoxic-free and had a wide range of applications. The findings could provide a new drug sustained-release system and hydrogel-microsphere assembly for urinary catheters. HighlightsThe microspheres presented a sustained release more than 40 days with a remarkable initial burst release.The microspheres/catechol-modified chitosan (Chi-C)/silicon rubber system emerged stable binding ability in liquid environment more than 14 days.The Chi-C/chlorhexidine (CHX)+triclosan (TCS) microspheres system presented better antimicrobial property for entire experiment period.The coated samples showed no significant difference for relative growth rate (RGR) compared to different groups.

Advances in Filament Structure of 3D Bioprinted Biodegradable Bone Repair Scaffolds.

Conventional bone repair scaffolds can no longer meet the high standards and requirements of clinical applications in terms of preparation process and service performance. Studies have shown that the diversity of filament structures of implantable scaffolds is closely related to their overall properties (mechanical properties, degradation properties, and biological properties). To better elucidate the characteristics and advantages of different filament structures, this paper retrieves and summarizes the state of the art in the filament structure of the three-dimensional (3D) bioprinted biodegradable bone repair scaffolds, mainly including single-layer structure, double-layer structure, hollow structure, core-shell structure and bionic structures. The eximious performance of the novel scaffolds was discussed from different aspects (material composition, ink configuration, printing parameters, etc.). Besides, the additional functions of the current bone repair scaffold, such as chondrogenesis, angiogenesis, anti-bacteria, and anti-tumor, were also concluded. Finally, the paper prospects the future material selection, structural design, functional development, and performance optimization of bone repair scaffolds.

In situ Synthesizing Carbon-Based Film by Tribo-Induced Catalytic Degradation of Poly-α-Olefin Oil for Reducing Friction and Wear.

Reducing friction and wear in a convenient and economical way has always been desired for industrial production. Here, a carbon-based film with excellent friction-reducing and antiwear abilities was formed in situ from the degradation of poly-α-olefin oil (PAO10) on the friction interfaces of the MoN/Pt coating sliding against the Si3N4 ceramic ball during the rubbing process. The MoN/Pt coating was prepared on stainless steel by direct current magnetron sputtering, in which an active 10 nm Pt layer grew well on the MoN layer. The MoN/Pt coating, lubricated by trace amounts of 5 mL PAO10 oil, exhibited a super low friction coefficient of 0.042 and an extremely low wear rate of 1.08 × 10-8 mm3 (N m)-1 after a long duration of applied friction under a high Hertz contact stress of 1.7 GPa. Raman spectra and transmission electron microscopy images revealed that the carbon-based film was composed of amorphous carbon phase dotted with sporadic Pt, MoO3, and SiO2 crystal phases. Molecular dynamics simulations illustrated that the MoN/Pt coating had catalytic action and resulted in the degradation of PAO10 during the rubbing process, which corresponded to the formation of the amorphous carbon-based film on the wear surfaces.

[Anthropology play a key role in simulated portrait].

The technology of simulated portrait played a key role in criminal cases' deterction recently, while anthropology is attached to it tightly. This paper analyzed and discussed the impact of anthropology in simulated portrait by means of studying the relationship between races, regions figures skeletons and physiognomy.